骨断层显像与同机定位CT进行图像融合对诊断脊柱骨转移性病变的临床应用价值  

Evaluation of clinical value of fusion imaging of ^(99m)Tc-MDP SPECT CT in the diagnosis of spinal metastasis

作　　者：岳明纲[1] 王茜[1] 秦淑玲[1] 张彩群[1] 聂玉新[1] 王玉[1] 梁铁军[1] 

机构地区：[1]北京大学人民医院核医学科,北京100044

出　　处：《中国临床医学影像杂志》2006年第4期202-204,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨带有低能量CT的99mTc-MDPSPECT骨显像所产生的骨断层、CT及融合图像对鉴别脊柱良恶性病变的临床价值,评价同机定位CT在诊断中的作用。方法:49例在常规全身骨显像中表现为仅脊柱出现异常核素浓聚灶(病灶数目≤3个)的患者,行局部骨断层,同时获得局部骨断层图像、同机定位CT图像以及两者的融合图像。所有病例均以病理、1个月内磁共振结果或1年以上随诊为最终诊断结果。结果:局部骨断层、同机定位CT和融合图像对49例患者的94个病变椎体诊断的灵敏性分别为81.4%、86.0%和100%,特异性分别为72.5%、98.0%和96.1%。说明融合图像不但可以对病灶的解剖位置精确定位,而且明显提高了诊断的灵敏性和特异性。此外同机定位CT图像在诊断过程中比较令人满意,但是在细小病变的判断时还应慎重以免造成假阳性;当局部骨断层与同机定位CT在诊断时不一致时,应反复对比图像和相互补充信息,也可以避免一些假阳性产生。结论:局部骨断层与同机定位CT所产生的融合图像对恶性肿瘤椎体转移的诊断具有较高的临床应用价值,应该作为全身骨显像必要的补充检查方法。Objectives： To assess the clinical value of ^99mTc-MDP SPECT, low-dose CT and fusion imaging used in differentiating malignancy from benignancy in spinal diseases and the value of low-dose CT for diagnosis. Methods： Using GE- Millennium VG with Hawkeye, ^99mTc-MDP SPECT/CT was performed in 49 patients with abnormal uptake only in spine（lesion number≤3） by ^99mTc-MDP scanning, which produced ^99mTc-MDP SPECT, low-dose CT and fusion imaging. All patients were diagnosed by MRI or high-resolution CT within a month, pathology or follow-up more than one year. Results： The diagnostic sensitivity of ^99mTc-MDP SPECT, low-dose CT and fusion imaging for 49 patients was 81.4%, 86.0% and 100%, respectively. The specificity of three types of imaging was 72.5%, 98.0% and 96.1%, respectively. It proved that ^99mTc-MDP SPECT/CT could not only provide the precise anatomic definition of lesions, but significantly improve the diagnostic sensitivity and specificity. In addition, to decrease the false positive cases, should analyze the small lesion sites with caution, although low-dose CT was satisfying in diagnosis; when low-dose CT did not accord to ^99mTc-MDP SPECT, should compare them through and through. Conclusion： Fusion imaging of ^99mTc-MDP SPECT and low-dose CT provided a significant clinical value for vertebral metastatic tumor and it should be used as a supplementary examination to the ^99mFc-MDP scintigraphy.

关 键 词：脊柱疾病 体层摄影术 X线计算机 

分 类 号：R681.5[医药卫生—骨科学] R814.42[医药卫生—外科学]